Church Data Form

Instructions Please fill out the following information to update and add new information for our church membership records. We will not publish all of this information, but need it for the official church records. Thank you for your help.
First Name *
Middle Name
Last Name *
Preferred Name
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Email Address *
Date of Birth *
Place of Birth *
Primary Phone *
Alternate Phone
Employer
Occupation
Work Phone
Work Extension
Relationship Status *
SingleMarriedDivorcedWidow(er)SeparatedPartnered
Marriage Date
Maiden Name
Spouse's/Partner's Name
Father's Full Name
Mother's Full Maiden Name
Date of Baptism
Church, City, State of Baptism
Sponsors for Baptism
Date of Confirmation
Church, City, State of Confirmation
Comments
Skills/Interests *
Emergency Contact Names and Phone Numbers
If you wish, please list the names and phone numbers of people you would like us to contact in the event of an emergency.